| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
4,392 |
2,260 |
$687K |
| 17110 |
|
3,334 |
2,904 |
$206K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,441 |
5,249 |
$158K |
| 73630 |
|
6,150 |
3,311 |
$137K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,992 |
1,694 |
$74K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
205 |
138 |
$68K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
843 |
571 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,635 |
1,298 |
$58K |
| 11056 |
|
2,296 |
2,035 |
$40K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
553 |
383 |
$34K |
| 11721 |
|
1,839 |
1,667 |
$24K |
| 11720 |
|
2,604 |
2,376 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
381 |
310 |
$24K |
| 29540 |
|
1,742 |
1,393 |
$21K |
| 99243 |
|
367 |
287 |
$19K |
| 10061 |
|
217 |
160 |
$11K |
| G0127 |
Trimming of dystrophic nails, any number |
1,565 |
1,429 |
$11K |
| 73620 |
|
630 |
293 |
$10K |
| 29580 |
|
253 |
160 |
$6K |
| 11719 |
|
518 |
464 |
$4K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
39 |
19 |
$3K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
38 |
13 |
$3K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
24 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
27 |
$175.05 |